West Hertfordshire NHS Trust, facing a �40m debt, said it is closing Hemel Hempstead Hospital's A&E department and relocating other services to Watford.

Critics said the decision will cost hundreds of jobs and is the result of budget overspends not clinical needs.

Trust chief executive David Law said financial constraints were a cause.

He said: "If you take something like a heart attack. If we pitched up at Watford at the moment, there are no suitable cardiac treatment facilities so we would have to transfer people from there.

"We cannot afford them at both Watford and Hemel Hempstead so the best way to provide safe care for people is to concentrate them on one site."

We have had wide ranging discussions with local stakeholders. I would wish to continue these discussions in the coming months and years Prof Thomas Hanahoe

MP for Hemel, Mike Penning, said the trust had ignored what people have told it during the consultation period.

He said: "I'm appalled and disgusted but not surprised. The consultation from day one was bogus and driven by financial problems rather than clinical care.

"Only 5% of consultees put in thoughts about the restructure and they said to leave the hospital alone, that it was relatively new, had good facilities and was built for the community but the trust ignored all that."

Trust chairman Prof Thomas Hanahoe said: "Throughout our 100-day consultation process we have listened to the views, ideas and concerns of patients, residents and other interested parties.

"We have had wide ranging discussions with local stakeholders. I would wish to continue these discussions in the coming months and years."